Knowledge Management - Synopsis
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Knowledge Management (KM) provides high-level data and knowledge organization skills to optimize the enterprise clinical, research, and educational initiatives. Collaborating with clinicians and researchers, highly trained information specialists embed best practices in organizing, structuring and reusing the institution's knowledge. The information specialists that constitute the Knowledge Management team, in addition to their unique expertise in library and information science, also hold deep knowledge and expertise in the areas of adult learning, health literacy, molecular biology, public health, pharmacology and communication. Current knowledge management services include expert genetics/molecular biology information assistance to support biomedical research and in-depth clinical evidence to inform the development of local and national patient care guidelines.
Evidence-based Practice Support:
The Knowledge Management (KM) team at Vanderbilt University Medical Center (VUMC) employs a matrix of strategies to foster evidence-based medicine (EBM) practice. Through the Digital Library, the team provides access to critical evidence-based resources including UpToDate®; Cochrane Database of Systematic Reviews, Reviews of Effects, and Register of Controlled Trials; ACP Journal Club as well as to globally accessible EBM resources such as the National Guideline Clearinghouse™. The Digital Library also features KM's internally-developed EBM databases such as the Clinical Informatics Consult Service (CICS) Evidence Based Site, which houses evidence syntheses created in response to complex clinical queries, and the Pathway/Order Set Literature Locator, which contains expert search strategies and summaries of literature to support evidence-based development of standardized clinical practice. Access to key National Center for Biotechnology Information resources including PubMed, GenBank™, Entrez Gene™, and Map Viewer™, as well as others such as PharmGKB, Protein Data Bank (PDB), UCSC Genome Browser, Database of Genomic Variants (DGV), OpenHelix, OMIM and TRANSFAC is available throughout the Medical Center. In addition, the Medical Center information systems are accessible via the Digital Library.
Clinical Programs and Services Facilitator:
The Knowledge Management team is committed to service, and its most important resource is the expertise of its staff. Information specialists help students, residents and faculty stay abreast of the latest findings in the literature by actively participating on clinical rounds and providing targeted support to researchers. The KM team has pioneered combining clinical informationist expertise with informatics tools as an effective strategy for delivering evidence needed to support patient care. Key examples of these interventions are: 1) integration of an EBM information basket into the medical record system (Starpanel), used by clinicians to request evidence filtered packets that are relevant and patient-specific and 2) the information provided directly to patients through the My Health At Vanderbilt portal to aid their understanding of lab data, and most recently, the genetic information that is being included in their record. In addition to working as clinical and research informationists, KM information specialists participate in multidisciplinary teams throughout the Medical Center, supporting a variety of programs such as pathways/order sets development, the Institutional Review Board (IRB), and a variety of patient information services.
The Knowledge Management team has also been an integral part of Vanderbilt's AHRQ-funded Evidence-based Practice Center (EPC) since its inception in 2007 to assess the feasibility and utility of topics for comparative effectiveness review and author systematic reviews to evaluate evidence on various clinical issues. The team serves as essential participants in all phases of the systematic review process, including authoring content in the final report and co-authoring peer reviewed manuscripts.
Knowledge Management's research interests include integrating evidence into the patient care and research workflow using informatics applications; assessing various stakeholder groups' interaction with health information; education, skills development, and leadership development of information professionals; optimal selection and use of information resources; health literacy projects and interventions; organizational knowledge management; and digital library development. The KM team pioneered a new form of patient educational intervention that is centered on two key elements: literacy and learning styles. Through a research grant from the Institute of Museum and Library Services, conducted a series of studies to investigate both the effectiveness and applicability of this newly designed educational intervention. Data collected from an emergency medicine clinical trial validated the approach in hypertensive patients. Through the grant work, the team explored a similar experiment with a different population in the Vine Hill Clinic for both hypertension and diabetes (IMLS National Leadership Grant LG-06-10-0186-10 December 1, 2010 - November 30, 2012. Using Patient Literacy Levels and Learning Style Preferences to Optimize the Delivery of Health Information). This research project established an infrastructure for developing customized information prescriptions that can be broadly adapted for use in varied care settings and with varied health conditions. In December 2013, the Knowledge Management team will extend the principles learned from this project with a new grant (IMLS National Leadership Grant LG-06-13-0180-13. Using Health Literacy and Learning Styles to Guide Oncology Patients through the Pharmacogenetic Maze) to develop a reusable model for delivering consumer-friendly pharmacogenetic information by adapting to appropriate learning styles and health literacy level.
Toward Personalized Medicine:
The Knowledge Management team aims to advance the knowledge base and capacities of VUMC for its personalized medicine missions. Knowledge Management team members are heavily embedded into VUMC's multidisciplinary Diagnostic Management Teams (DMTs) which are designed to provide laboratory test interpretations to aid VUMC clinicians to understand results of complex diagnostic tests. With their knowledge of pharmacogenetics, KM team members provide evidence-based support for coagulopathy, hematopathology interpretations; preliminary work with the upcoming Breast DMT is also underway. As contributors of the VUMC's Clinical & Translational Science Award project, KM information scientists aid in the integration of genetic information into the electronic medical record, helping physicians match drugs and dosage to patients. Evidence synthesized by KM team members also plays in integral part in VUMC's publicly available personalized cancer decision support tool, My Cancer Genome. For My Health at Vanderbilt's personalized medicine component, KM information scientists apply the unique combination of pharmacogenetics expertise and knowledge of genetic literacy, to develop consumer-friendly materials aimed at facilitating patient understanding of complex genetic information.
KM information scientists provide training to VUMC personnel and research community on pharmacogenetics and personalized medicine concepts and resources. In addition to group training, KM information scientists also offer drop-in office hours for VUMC practitioners, researchers, and students to gain assistance for using in-depth genetics and molecular biology databases.
Last updated: October 28, 2013